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Dr. Rangan: What happens is that the alcohol competes with the antifreeze so that the liver will have limited ability to convert the antifreeze into a toxic byproduct. By having the alcohol aboard, you can interfere with that process. That way, the antifreeze will stay as antifreeze and not convert into a toxic product and then kinda get peed out. This is a recommended therapy that is in the book.These days, it’s a little archaic, because we have other mechanisms, and other medications that we use for that kind of poisonings, but for a dog, I can see any veterinarian going, "Let’s just go ahead and do that," because it’s relatively cheap therapy. There are other things you can do, like dialysis, which, you know would be a pretty expensive procedure for a dog.So if I were at an isolated hospital out in the countryside or something like that, and I drank antifreeze, is it possible that they would get me soused on, like, moonshine or something?
If you were in a rural setting, and you came into my emergency department, I’m probably going to start you on an alcohol intravenous drip, and give you alcohol intravenously. That’ll definitely do in that case.
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It’s just called "100 percent ethanol." It’s all alcohol and nothing else, and it’s in an IV container, and we hook a tube up to it, and we stick it right into your vein. And that way we can adjust the rate, so we can adjust your alcohol level so to speak, and get it to a level that’s therapeutic. So it’s not like we take vodka off the shelf and start shoving it down your throat. It’ll get you kinda drunk. No question about it. But it is the therapy I would use if I didn’t have those other resources available to me.If I’ve called poison control because I’ve had a bunch of poison, and the ambulance isn’t there yet, would it ever be a good idea for me to just knock some back?
It probably would not be a good idea to do it on your own, but let’s suppose—and I’m just thinking of a very extreme sort of scenario—let’s suppose you call poison control, and you’re in a very remote area, and we coordinated with the 911 people and determined that it’s gonna take more than—l dunno—two hours to get to you because you’re on some hilltop, and we’ve gotta get a helicopter to you, or something. That might be a situation where we go ahead and say, "You know what? Find some alcohol in your house and start drinking it.” That’s sort of under medical supervision, so to speak, because we’re the experts at poison control telling you to do it. That would probably never actually happen. We would caution anyone from doing it on their own.
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Ethylene glycol, despite the fact that it sounds like a very nasty chemical, tastes like sugar water when you actually drink the stuff, so you’ll see children taking it, and it doesn’t taste very bitter like other industrial compounds. With a dog, you might see them maybe around a junkyard where there’s lots of old cars, and they’ll just be sitting there licking a radiator, and just getting all the ethylene glycol off that. And you sometimes get very severe poisoning in animals because of that.What would be the principle that would make it seem like drinking would help with a snake bite? Why would that seem logical?
That’s just sort of an old folk remedy. It just used to be presumed long ago if you get bit by a snake, death might be right around the corner, so you drink a whole bunch of alcohol. There are also people who say things like, “Oh I need the alcohol to neutralize the snake poison that’s circulating in my body.” They heard something somewhere, maybe from a television show, or maybe some bad research on the internet.There are certain snakes out there that can give you all kinds of crazy symptoms that may include disruptions in your ability to clot your blood, swelling, and damage around the site of the bite, or even respiratory problems or mental-status problems, but if you go ahead and drink alcohol, you may interfere with my medical interpretation of what’s going on with you. If you have a bunch of alcohol, I'll ask myself, “Is this person looking like this because they drank too much, or is it because of the snake bite?" And that clouds our ability to be able to treat you.Thanks, Dr. Rangan!Follow Mike Pearl on Twitter
